Regular Mindful Yoga Practice as a Method to Improve Androgen Levels in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Trial

Abstract

Background: Holistic approaches are needed to complement existing therapies for polycystic ovary syndrome (PCOS), a common disorder affecting the health of reproductive-aged females.Objective: To determine whether thrice-weekly mindful yoga practice improves endocrine, cardiometabolic, or psychological parameters in women with PCOS.Methods: Thirty-one women with PCOS between the ages of 23 and 42 years and living in Erie County, Pennsylvania, were recruited for this randomized, controlled study arm, which was part of a larger 3-part investigation. Women were randomly assigned to either a mindful yoga intervention group or no intervention (control) group. Group classes were 1 hour, thrice weekly. Initial endocrine, cardiometabolic, and psychological measurements were compared with measurements taken after the 3-month intervention period. Measurements included free testosterone, dehydroepiandrosterone, androstenedione, body mass index, waistto-hip ratio, fasting blood glucose and insulin levels, and anxiety and depression scores.Results: Twenty-two women completed the 3-month intervention period, 13 in the mindful yoga group and 9 in the control group. Paired comparisons of pre-and postintervention parameters indicated that women who completed the mindful yoga intervention had significantly lower free testosterone levels (5.96 vs 4.24 pg/mL; P<.05) and dehydroepiandrosterone levels that trended lower. Improved testosterone may persist for several months after completion of a 3-month, thrice-weekly mindful yoga intervention. Additionally, improvements were seen in measures of anxiety and depression. Conclusion:The improvements observed suggest that regular mindful yoga practice can be a useful complementary therapeutic option for women with PCOS, particularly for improving serum androgen levels, a hallmark feature of PCOS. This improvement occurred in the absence of weight loss and may persist even if there is a lapse in practice. (ClinicalTrials.gov No. NCT03383484)

A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome

“…In an RCT with adult women with PCOS, the three-month intervention included a guided yoga class for one hour three days a week, with pranayama breathing exercises, restorative asanas, vinyasa flows, mindfulness, and meditation. Participants in the yoga group had lower fT that persisted three months after the conclusion of the intervention, lower APN, and DHEA that trended lower; A4, DHEA-S, FI, and HOMA-IR did not change [ 131 ].…”

“…There have only been two reported studies on yoga intervention in adolescents or women with PCOS to date. In each, an improvement in TT [ 130 ] or fT was observed [ 132 ], and DHEA trended lower, although DHEA-S and A4 did not change in a study with adult women [ 131 ].…”

“…In the RCT with yoga intervention in adolescent girls with PCOS, FI and HOMA-IR improved [ 130 ], although this was not the case in an RCT with adult women with PCOS [ 131 ]. The average BMI in the adult group was greater than that in the adolescents, and women with PCOS may have already had established metabolic dysfunction, which could potentially explain this difference.…”

“…Adipokines were not examined in the studies with PRT interventions [ 126 , 127 , 128 ], or in the study of yoga intervention in adolescents with PCOS [ 130 ]. APN decreased in women with PCOS following a three-month yoga intervention [ 131 ].…”

The Complementary and Alternative Medicine for Polycystic Ovary Syndrome: A Review of Clinical Application and Mechanism

“…Yoga, a form of holistic mind-body medicine developed thousands of years ago, is a low-impact exercise that can help people maintain balance among physical, psychological, mental, sentimental, and spiritual aspects of life [ 111 ]. As a branch of CAM, it is used to treat many different diseases, such as hypertension, asthma, low back pain, arthritis and pain, stress management, and PCOS [ 112 ]. A study has shown that yoga can help control endocrine function and relieve symptoms of PCOS [ 113 ].…”